Total Joint Commission
Ties
The cuffs of a sterile gown are always considered sterile
False; once the hands have moved through the cuff they are no longer sterile
An anesthesia provider is seen wearing a fabric-covered stethoscope in the OR. What are your concerns?
Fabric coverings cannot be worn in the OR.
Stethoscopes should not be worn around the neck
Why would a delayed primary closure be utilized?
Monitor infection or tissue death, wound packing, allow for assessment of wound
What is 'knot tensile strength?'
The force a the suture strand can withstand before it breaks when knotted
After surgical hand antisepsis, hands and arms must be dried thoroughly to prevent this
Strike through
A drape with an opening to expose specific anatomy for incision
You see someone in surgical attire walking around the department but they are not wearing a badge and they do not seem to know where they are going. What actions do you take?
Escalate through your chain of command
Offer to assist this person by bringing them to the main desk for assistance
How long does the remodeling phase take?
Considerations with natural absorbable suture
Packed with fluid, will dry out if opened too early
Irritating for ophthalmic surgery, should be rinsed
The goal of aseptic technique are what 3 things?
Optimized wound healing, minimizing length of recovery from surgery, infection prevention
What is an apature drape?
Adhesive plastic sheeting with a fenestration
Upon entering your surgical suite in the morning you notice the room feels balmy. The humidity reads 65%. What actions do you take?
Notify charge RN and team of possible room delays
Contact facilities to have them adjust humidity. Discuss with them reducing room temperature to assist in fix
3 phase of wound healing
1. Inflammation phase
2. Proliferation phase
3. Remodeling phase
How long does it take a synthetic absorbable suture to absorb?
3 weeks to 6 months
What medication is given in the event of local anesthetic systemic toxicity?
20% lipids
Define PNDS
Perioperative Nursing Data Set
You go to grab a wrapped instrument pan from SPD and notice dust gathered on it, likely form recent construction. Can this pan be utilized?
No, it should be considered contaminated
Name 4 factors that affect wound healing
Hemostasis, hypothermia, tissue handling, maintenance of sterile technique, stress on wound after surgery, etc.
Hair should be clipped in area of incision
What are the goals of surgical skin antisepsis?
1. to remove soil and transient microorganisms form the skin
2. to reduce the resident microbial count to below pathogenic levels in a short period of time with the least amount of tissue irritation
3. to inhibit rapid rebound growth of microorganisms
What two types of microorganisms reside in the two layers of skin?
Transient bacteria and resident microorganisms
Skin can be sterilized
False
Name the 5 steps your body takes in wound healing to prevent infection
1. Hemostasis
2. Clean up pathogens/debris in wound
3. Seal the wound against infection
4. Regenerate the natural epidermal covering
5. Repair deeper tissue damage
Characteristics of antimicrobial agents used in surgical skin antisepsis
1. broad spectrum
2. high log reduction capability
3. persistent
4. Nonirritating
5. Nontoxic
6. Fast acting